Percutaneous Coronary Interventions in Patients With Prior Transcatheter Aortic Valve Replacement

Area of Science:

• Cardiology
• Interventional Cardiology
• Cardiac Surgery

Background:

• Coronary access following transcatheter aortic valve replacement (TAVR) presents significant technical challenges.
• Evaluating percutaneous coronary intervention (PCI) in patients who have undergone TAVR is crucial for managing cardiac health post-procedure.

Purpose of the Study:

• To assess the feasibility and technical success rate of PCI in patients previously treated with TAVR.
• To analyze the procedural and technical aspects of performing PCI after TAVR.

Main Methods:

• Retrospective analysis of patients undergoing PCI post-TAVR.
• Focus on procedural details, access routes, and specific techniques employed during PCI.
• Primary endpoint: technical success rate of PCI.

Main Results:

• PCI was performed in 44 patients (1.9%) after TAVR, with a high technical success rate of 96%.
• Common indications included stable angina and acute coronary syndromes; femoral access was predominant.
• Specific techniques like guide catheter extension and atherectomy were utilized in a subset of cases.

Conclusions:

• Coronary access and PCI are highly successful post-TAVR despite anatomical challenges, provided appropriate techniques are used.
• Increasing TAVR use in younger populations necessitates operator expertise in coronary access strategies for improved post-TAVR care.